A team from Finland investigated the occurrence of celiac disease in patients with severe liver failure.
Four patients with untreated celiac disease and severe liver disease were identified.
Furthermore, the occurrence of celiac disease was studied in 185 adults with previous liver transplantation. This was done by screening for serum immunoglobulin A endomysial and tissue transglutaminase antibodies.
Of the 4 patients with severe liver disease and celiac disease, 1 had congenital liver fibrosis, 1 had massive hepatic steatosis, and 2 had progressive hepatitis without apparent origin.
Three were even remitted for consideration of liver transplantation.
Hepatic dysfunction reversed in all cases when a gluten-free diet was adopted.
| Hepatic dysfunction in celiacs reversed in all cases when a gluten-free diet was adopted.
| Gastroenterology |
In the transplantation group, 8 patients (4%) had celiac disease.
Six cases were detected before the operation: 3 had primary biliary cirrhosis, 1 had autoimmune hepatitis, 1 had primary sclerosing cholangitis, and 1 had congenital liver fibrosis.
Only 1 patient had maintained a long-term strict gluten-free diet.
Screening found 2 cases of celiac disease, 1 with autoimmune hepatitis and 1 with secondary sclerosing cholangitis.
Dr Katri Kaukinen, of the Tampere University Hospital, Tampere, Finland, said on behalf of colleagues, "The possible presence of celiac disease should be investigated in patients with severe liver disease."
"Dietary treatment may prevent progression to hepatic failure, even in cases in which liver transplantation is considered," it was concluded.